{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T02:55:20Z","timestamp":1764557720520,"version":"3.41.2"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Previous studies have suggested a potential role for inhaled corticosteroids, such as budesonide, in reducing bronchopulmonary dysplasia (BPD) among preterm infants. The objective of our study was to investigate the effectiveness of intratracheal administration of corticosteroid with surfactant on the composite outcome of death or BPD at 36 weeks in extremely low birth weight (ELBW) infants.<\/jats:p><jats:p>This before\u2013after cohort study compared outcomes in ELBW infants with respiratory distress syndrome (RDS) who received intratracheal surfactant with budesonide to a historical cohort who received surfactant alone. Data were collected retrospectively for neonates in the surfactant group and prospectively for those receiving surfactant plus budesonide.<\/jats:p><jats:p>A total of 385 ELBW infants were included. Death or BPD occurred in 123\/203 (60.5%) in the surfactant with budesonide group versus 105\/182 (57.6%) in the surfactant group; adjusted odds ratio 1.10 (95% CI: 0.69\u20131.75; p\u2009=\u20090.69). Statistical analysis revealed no significant difference in the incidence of the composite primary outcome (death or BPD at 36 weeks of postmenstrual gestational age), and its components, between the two study groups.<\/jats:p><jats:p>In our study, coadministration of budesonide and surfactant was deemed safe and feasible among ELBW infants with RDS. However, we did not observe a significant reduction in the rates of composite or individual outcomes of death or BPD. Larger, randomized controlled trials are necessary to explore the potential advantages of this intervention.<\/jats:p>","DOI":"10.1055\/a-2506-2893","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T19:08:43Z","timestamp":1734635323000},"page":"1437-1444","source":"Crossref","is-referenced-by-count":1,"title":["Intratracheal Administration of Budesonide with Surfactant for Prevention of Death or Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants: A before\u2013after Study"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8353-5048","authenticated-orcid":false,"given":"Anish","family":"Pillai","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"},{"name":"Department of Neonatology and Pediatrics, Motherhood Hospital, Navi Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandkishor","family":"Kabra","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharayu","family":"Kothavade","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Chevle","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Sakharkar","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepika","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richa","family":"Choubey","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haribalakrishna","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jpeds.2021.11.049","article-title":"Evaluation of trends in bronchopulmonary dysplasia and respiratory support practice for very low birth weight infants: a population-based cohort study","volume":"243","author":"S M Lee","year":"2022","journal-title":"J Pediatr"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"17868","DOI":"10.1038\/s41598-023-45216-x","article-title":"Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China","volume":"13","author":"Y P Xu","year":"2023","journal-title":"Sci Rep"},{"issue":"14","key":"ref3","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1055\/s-0038-1655761","article-title":"Clinical outcomes among diagnostic subgroups of infants with severe bronchopulmonary dysplasia through 2 years of age","volume":"35","author":"G Akangire","year":"2018","journal-title":"Am J Perinatol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S1084-2756(02)00136-7","article-title":"Discharge and aftercare in chronic lung disease of the newborn","volume":"8","author":"R A Primhak","year":"2003","journal-title":"Semin Neonatol"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"303","DOI":"10.2165\/00148581-200406050-00004","article-title":"Bronchopulmonary dysplasia in preterm infants: pathophysiology and management strategies","volume":"6","author":"C T D'Angio","year":"2004","journal-title":"Paediatr Drugs"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/S0046-8177(98)90280-5","article-title":"Pathology of arrested acinar development in postsurfactant bronchopulmonary dysplasia","volume":"29","author":"A N Husain","year":"1998","journal-title":"Hum Pathol"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"e691","DOI":"10.1542\/neo.24-11-e691","article-title":"Postnatal corticosteroids to prevent bronchopulmonary dysplasia","volume":"24","author":"E A Jensen","year":"2023","journal-title":"Neoreviews"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1001\/jamapediatrics.2021.6619","article-title":"Interventions to prevent bronchopulmonary dysplasia in preterm neonates: an umbrella review of systematic reviews and meta-analyses","volume":"176","author":"T Abiramalatha","year":"2022","journal-title":"JAMA Pediatr"},{"issue":"04","key":"ref9","first-page":"CD013271","article-title":"Corticosteroids for the prevention and treatment of bronchopulmonary dysplasia: an overview of systematic reviews","volume":"4","author":"M van de Loo","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1016\/S0140-6736(16)00202-6","article-title":"Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial","volume":"387","author":"O Baud","year":"2016","journal-title":"Lancet"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1001\/jama.2018.21443","article-title":"Effect of hydrocortisone therapy initiated 7 to 14 days after birth on mortality or bronchopulmonary dysplasia among very preterm infants receiving mechanical ventilation: a randomized clinical trial","volume":"321","author":"W Onland","year":"2019","journal-title":"JAMA"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clp.2008.09.016","article-title":"Postnatal corticosteroids for bronchopulmonary dysplasia","volume":"36","author":"A H Jobe","year":"2009","journal-title":"Clin Perinatol"},{"issue":"12","key":"ref13","first-page":"CD002311","article-title":"Late (\u22657 days) inhaled corticosteroids to reduce bronchopulmonary dysplasia in preterm infants","volume":"12","author":"W Onland","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"L888","DOI":"10.1152\/ajplung.00477.2018","article-title":"Surfactant plus budesonide decreases lung and systemic inflammation in mechanically ventilated preterm sheep","volume":"316","author":"T B Kothe","year":"2019","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1038\/s41390-019-0663-6","article-title":"Surfactant and budesonide for respiratory distress syndrome: an observational study","volume":"87","author":"T B Kothe","year":"2020","journal-title":"Pediatr Res"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.5001\/omj.2021.84","article-title":"A randomized clinical trial of intratracheal administration of surfactant and budesonide combination in comparison to surfactant for prevention of bronchopulmonary dysplasia","volume":"36","author":"M M Gharehbaghi","year":"2021","journal-title":"Oman Med J"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"551","DOI":"10.24953\/turkjped.2020.04.004","article-title":"Intratracheal administration of budesonide with surfactant in very low birth weight infants to prevent bronchopulmonary dysplasia","volume":"62","author":"M Heo","year":"2020","journal-title":"Turk J Pediatr"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1164\/rccm.201505-0861OC","article-title":"Intratracheal administration of budesonide\/surfactant to prevent bronchopulmonary dysplasia","volume":"193","author":"T F Yeh","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"issue":"02","key":"ref20","first-page":"137","article-title":"Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants [in Chinese]","volume":"19","author":"J Pan","year":"2017","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"issue":"01","key":"ref21","first-page":"78","article-title":"Efficacy and safety of intratracheal administration of budesonide combined with pulmonary surfactant in preventing bronchopulmonary dysplasia: a prospective randomized controlled trial","volume":"24","author":"M M Liu","year":"2022","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4103\/jcn.jcn_52_23","article-title":"Budesonide and surfactant combination for treatment of respiratory distress syndrome in preterm neonates and evaluation outcomes","volume":"12","author":"F B Safa","year":"2023","journal-title":"J Clin Neonatol"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s12887-024-04736-9","article-title":"The impact of combined administration of surfactant and intratracheal budesonide compared to surfactant alone on bronchopulmonary dysplasia (BPD) and mortality rate in preterm infants with respiratory distress syndrome: a single-blind randomized clinical trial","volume":"24","author":"A Marzban","year":"2024","journal-title":"BMC Pediatr"},{"key":"ref24","first-page":"61","article-title":"The clinical study of budesonide combined with pulmonary surfactant to prevent bronchopulmonary dysplasia in premature infants","author":"J Su","year":"2019","journal-title":"Int J Pediatr"},{"issue":"07","key":"ref25","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1002\/ppul.23680","article-title":"Intratracheal administration of budesonide-surfactant in prevention of bronchopulmonary dysplasia in very low birth weight infants: a systematic review and meta-analysis","volume":"52","author":"R Venkataraman","year":"2017","journal-title":"Pediatr Pulmonol"},{"issue":"06","key":"ref26","first-page":"e100511","article-title":"A meta-analysis of the effects and safety of pulmonary surfactants","volume":"22","author":"B B He","year":"2020","journal-title":"Iran Red Crescent Med J"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"526","DOI":"10.21037\/tp-22-8","article-title":"A systematic review and meta-analysis of pulmonary surfactant combined with budesonide in the treatment of neonatal respiratory distress syndrome","volume":"11","author":"Z Yi","year":"2022","journal-title":"Transl Pediatr"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jped.2022.10.007","article-title":"Use of budesonide associated with a pulmonary surfactant to prevent bronchopulmonary dysplasia in premature newborns - a systematic review","volume":"99","author":"L HA Moraes","year":"2023","journal-title":"J Pediatr (Rio J)"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2174\/1574884710666150929100210","article-title":"Pharmacokinetics of budesonide administered with surfactant in premature lambs: implications for neonatal clinical trials","volume":"11","author":"J K Roberts","year":"2016","journal-title":"Curr Clin Pharmacol"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1038\/sj.jp.7210963","article-title":"Safety, reliability, and validity of a physiologic definition of bronchopulmonary dysplasia","volume":"23","author":"M C Walsh","year":"2003","journal-title":"J Perinatol"},{"issue":"05","key":"ref31","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1038\/s41390-018-0167-9","article-title":"The definition of bronchopulmonary dysplasia: an evolving dilemma","volume":"84","author":"J Ibrahim","year":"2018","journal-title":"Pediatr Res"},{"issue":"07","key":"ref32","doi-asserted-by":"crossref","first-page":"151638","DOI":"10.1016\/j.semperi.2022.151638","article-title":"Contributions of the NICHD neonatal research network to the diagnosis, prevention, and treatment of bronchopulmonary dysplasia","volume":"46","author":"E A Jensen","year":"2022","journal-title":"Semin Perinatol"},{"issue":"01","key":"ref33","first-page":"21","article-title":"What is a hemodynamically significant PDA in preterm infants?","volume":"14","author":"J L Shepherd","year":"2019","journal-title":"Congenit Heart Dis"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000658-197801000-00001","article-title":"Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging","volume":"187","author":"M J Bell","year":"1978","journal-title":"Ann Surg"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0031-3955(16)34975-6","article-title":"Necrotizing enterocolitis: treatment based on staging criteria","volume":"33","author":"M C Walsh","year":"1986","journal-title":"Pediatr Clin North Am"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/B978-0-444-64029-1.00008-4","article-title":"Preterm brain injury: germinal matrix-intraventricular hemorrhage and post-hemorrhagic ventricular dilatation","volume":"162","author":"L M Leijser","year":"2019","journal-title":"Handb Clin Neurol"},{"issue":"12","key":"ref37","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1001\/archopht.121.12.1684","article-title":"Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial","volume":"121","author":"Early Treatment For Retinopathy Of Prematurity Cooperative Group","year":"2003","journal-title":"Arch Ophthalmol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"626261","DOI":"10.3389\/fped.2021.626261","article-title":"Conservative management of patent ductus arteriosus in preterm infants-a systematic review and meta-analyses assessing differences in outcome measures between randomized controlled trials and cohort studies","volume":"9","author":"T Hundscheid","year":"2021","journal-title":"Front Pediatr"},{"issue":"11","key":"ref39","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1056\/NEJMoa2207418","article-title":"Expectant management or early ibuprofen for patent ductus arteriosus","volume":"388","author":"T Hundscheid","year":"2023","journal-title":"N Engl J Med"},{"issue":"22","key":"ref40","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1001\/jama.2024.17380","article-title":"Intratracheal budesonide mixed with surfactant for extremely preterm infants: the PLUSS randomized clinical trial","volume":"332","author":"B J Manley","year":"2024","journal-title":"JAMA"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"e3065","DOI":"10.1055\/s-0043-1776416","article-title":"Intratracheal instillation of budesonide-surfactant for prevention of bronchopulmonary dysplasia in extremely premature infants","volume":"41","author":"K Dolma","year":"2024","journal-title":"Am J Perinatol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2506-2893.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T22:38:52Z","timestamp":1753223932000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2506-2893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,7,22]]},"published-print":{"date-parts":[[2025,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2506-2893","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2024,12,19]]},"published":{"date-parts":[[2024,12,19]]}}}